Traumatic Bone Cyst in the Mandibular Symphysis : Case Reports

Traumatic bone cyst (TBC) is an asymptomatic lesion seen most in adolescents. TBC is found incidentally on routine panoramic examinations and appears as a relatively well-demarcated unilocular radiolucency with scalloped margins. Histological examination reveals a vacant cavity of cancellous bone usually unlined or very occasionally lined with a thin connective tissue layer. The lack of lining epithelial membrane is common histological feature. The most affected site is between the mandibular canine and third molar. The involvement of the mandibular symphysis is rare. The etiopathogenesis of the TBC is unclear. TBC is treated with surgical exploration and curettage; new bone is formed in place of the lesion within 6 - 12 months of surgery. Diagnosis of TBC prior to surgical intervention has limitations in most of the cases. Both of our patients were diagnosed through radiological examination and biopsy. Neither patient had a history of trauma. After surgery, the panoramic radiograph and CBCT were used to confirm bone healing.

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Therapeutic Management of a Substantial Pelvic Aneurysmatic Bone Cyst Including the Off-Label Use of Denosumab in a 35-Year-Old Female Patient

Case Reports in Orthopedics ◽

10.1155/2017/9125493 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

D. Ntalos ◽

M. Priemel ◽

C. Schlickewei ◽

D. M. Thiesen ◽

J. M. Rueger ◽

...

Keyword(s):

Monoclonal Antibody ◽

Female Patient ◽

Therapeutic Agent ◽

Surgical Intervention ◽

Case Reports ◽

Bone Cyst ◽

Off Label Use ◽

Aneurysmal Bone Cysts ◽

Promising Therapeutic Agent

Aneurysmal bone cysts (ABC) are benign bone tumors, which are highly vascularized. The main course of treatment is curettage followed by bone grafting or cement insertion. Still recurrence remains a main problem for patients. Denosumab is a monoclonal antibody, which acts as an inhibitor of the RANK/RANKL pathway, diminishing bone turnover. Recent case reports have shown that Denosumab can be a promising therapeutic agent for people suffering from therapy-resistant ABC. We report the case of a 35-year-old female patient presenting with a pronounced ABC of the pelvis. Since the tumor was inoperable, Denosumab was administered, leading to a significant shrinkage of the lesion, which allowed surgical intervention. Upon recurrence, Denosumab was restarted putting the patient once more into remission. Follow-up was four years overall with a clinical and radiological stable disease for fifteen months after final discontinuation of the monoclonal antibody. Therefore, our case further underlines the potential of Denosumab in the treatment of ABC.

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More than Garden Variety: Massive Vegetations from Infective Endocarditis

Pathogens ◽

10.3390/pathogens9120998 ◽

2020 ◽

Vol 9 (12) ◽

pp. 998

Author(s):

Christopher Radcliffe ◽

Joyce Oen-Hsiao ◽

Matthew Grant

Keyword(s):

Heart Failure ◽

Infective Endocarditis ◽

Methicillin Resistant Staphylococcus Aureus ◽

Surgical Intervention ◽

Case Reports ◽

Source Control ◽

Valvular Regurgitation ◽

Vancomycin Therapy ◽

Staphylococcus Aureus Bacteremia ◽

History Of

Infective endocarditis classically involves non-sterile vegetations on valvular surfaces in the heart. Feared complications include embolization and acute heart failure. Surgical intervention achieves source control and alleviates valvular regurgitation in complicated cases. Vegetations >1 cm are often intervened upon, making massive vegetations uncommon in modern practice. We report the case of a 39-year-old female with history of intravenous drug abuse who presented with a serpiginous vegetation on the native tricuspid valve and methicillin-resistant Staphylococcus aureus bacteremia. The vegetation grew to 5.6 cm by hospital day two, and she successfully underwent a tricuspid valvectomy. Six weeks of intravenous vancomycin therapy were completed without adverse events. To better characterize other dramatic presentations of infective endocarditis, we performed a systematic literature review and summarized all case reports involving ≥4 cm vegetations.

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Apendicitis aguda de presentación atípica, un reto diagnóstico. Reporte de caso y revisión de la literatura

Revista Médica del Hospital José Carrasco Arteaga ◽

10.14410/2021.13.1.cc.10 ◽

2021 ◽

Vol 13 (1) ◽

pp. 61-65

Author(s):

Karla del Cisne Martínez Gaona ◽

David Esteban Barzallo Sánchez ◽

Mónica Eulalia Galarza Armijos

Keyword(s):

Surgical Intervention ◽

Case Reports ◽

Iliac Fossa ◽

Exploratory Laparotomy ◽

Poor Quality ◽

High Clinical Suspicion ◽

History Of ◽

The Right ◽

Prolonged Hospital ◽

Health Care Associated Pneumonia

BACKGROUND: Atypical appendicitis corresponds to approximately 39.3% of all appendicitis cases. Typically located appendicitis begins with acute pain around the belly button, which will later migrate to the right iliac fossa; however, the patient’s condition must be oriented in details that arise from a meticulous anamnesis, considering the patients history and the development of the symptoms. CASE REPORTS: 17-year-old male patient with history of right hepatectomy 15 years ago. He presented with five day evolution continuous abdominal pain, located in the right upper quadrant, nausea, vomiting and fever. Complementary laboratory tests evidenced: leukocytosis, neutrophilia, elevated procalcitonin and CRP. Tomography was suggestive of an inflammatory process in the lower right thoracic region and the right upper quadrant. A diagnostic laparoscopy was performed, it was converted into an exploratory laparotomy, showing purulent fluid in the right parietocolic gutter, adhesions, appendicular plastron in the right sub and retrohepatic region formed by the cecum, distal ileum, omentum and appendix. Retrohepatic appendix with perforation in the middle third, appendicular base and poor quality cecum. An appendectomy, cavity lavage was performed, with placement of a drain. EVOLUTION: During the postoperative period, the patient had a poor clinical evolution, with health care associated pneumonia, in addition to the need for a second surgical intervention due to the formation of a sub-hepatic collection. After 13 days of hospital care, after the second surgical intervention, he presented an adequate recovery and was discharged from the hospital. CONCLUSION: Physicians must have a high clinical suspicion of atypical location appendicitis in the presence of acute abdomen; since a late diagnosis of this cases increases the risk of complications, with perforation and peritonitis and prolonged hospital stay. The first-line treatment for complicated appendicitis is surgical intervention.

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Asynchronous Bilateral Ovarian Torsion: Three Cases, Three Lessons

Case Reports in Pediatrics ◽

10.1155/2017/6145467 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

M. C. Lucchetti ◽

C. Orazi ◽

A. Lais ◽

M. L. Capitanucci ◽

P. Caione ◽

...

Keyword(s):

Children And Adolescents ◽

Surgical Intervention ◽

Case Reports ◽

Young Patients ◽

Clinical History ◽

Ovarian Torsion ◽

Review Of The Literature ◽

Study Objective ◽

Future Fertility ◽

History Of

Background. Ovarian torsion (OT) is a serious condition, and delay in surgical intervention may result in loss of the ovary. Children and adolescents who have suffered from ovarian torsion may be at risk for asynchronous torsion of the contralateral ovary. Study objective. Three cases of asynchronous bilateral ovarian torsion were reported to analyse clinical history of three patients, to review the current literature, and to draw a conclusion for future treatment. Design. Case reports and review of the literature. Result. When a prepubertal girl presents with an ovarian torsion, several considerations have to be taken in account in order to preserve her future fertility; in particular, the pediatric surgeon/gynecologist has to preserve as much as possible the twisted ovary in addition to considering the fate of the contralateral ovary. Summary and Conclusions. Pelvic pain in a young girl has always raised the clinical suspect of an ovarian torsion; the possibility of asynchronous bilateral ovarian torsion is rare, but it is described in the literature and has catastrophic consequences; this condition has to be known and treated in the proper way by pediatric surgeons as well as by gynecologists in order to maximize the future fertility of the young patients.

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Herpetic Whitlow of the Hand in Infants

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1710199 ◽

2020 ◽

Author(s):

Mohammad M. Al-Qattan ◽

Nada G. AlQadri ◽

Ghada AlHayaza

Keyword(s):

Bacterial Infection ◽

Case Reports ◽

Case Series ◽

Individual Case ◽

Senior Author ◽

Secondary Bacterial Infection ◽

Clinical Appearance ◽

History Of ◽

Mode Of Transmission ◽

Time Of Presentation

Abstract Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants. Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome. Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection. Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

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Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

African Journal of Urology ◽

10.1186/s12301-019-0006-1 ◽

2019 ◽

Vol 25 (1) ◽

Author(s):

Danielle Whiting ◽

Ian Rudd ◽

Amit Goel ◽

Seshadri Sriprasad ◽

Sanjeev Madaan

Keyword(s):

Case Reports ◽

Case Presentation ◽

Open Adrenalectomy ◽

Large Size ◽

History Of ◽

Loin Pain ◽

Benign Tumours ◽

Spontaneous Haemorrhage ◽

Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

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Clozapine-induced stuttering in the absence of known risk factors: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02803-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Florence Jaguga

Keyword(s):

Risk Factors ◽

Family History ◽

Side Effect ◽

Case Reports ◽

Extrapyramidal Symptoms ◽

Prior History ◽

Case Presentation ◽

Rare Side Effect ◽

History Of ◽

Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

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Sirenomelia: two case reports

Journal of Medical Case Reports ◽

10.1186/s13256-021-02699-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Asiyeh Shojaee ◽

Firooze Ronnasian ◽

Mahdiyeh Behnam ◽

Mansoor Salehi

Keyword(s):

Case Reports ◽

Three Dimensional ◽

First Trimester ◽

Mendelian Inheritance ◽

Lower Limbs ◽

Congenital Deformity ◽

White Family ◽

Her Family ◽

Caudal Regression ◽

History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

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Severe COVID-19 with acute respiratory distress syndrome (ARDS) in a sickle cell disease adult patient: case report

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01412-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marion Teulier ◽

Alexandre Elabbadi ◽

Grigorios Gerotziafas ◽

François Lionnet ◽

Guillaume Voiriot ◽

...

Keyword(s):

Sickle Cell ◽

Case Reports ◽

Cor Pulmonale ◽

Point Of View ◽

Nasopharyngeal Swab ◽

Prevention Policy ◽

Cord Injury ◽

History Of ◽

Pulmonary Arterial ◽

Venovenous Ecmo

Abstract Background Sickle-cell anaemia is a widespread genetic disease prevalent worldwide among African and African-American populations. The pathogenesis is most often revealed by pulmonary conditions, including acute thoracic syndrome, which is affecting the life expectancy of these populations. The global spread of CoV2-SARS infection with a respiratory tropism, endothelial damages and procoagulant status endangers the SCD population. However, with only a few case reports, consequences of the Covid-19 pandemic on SCD population remain poorly known. Case presentation We report a case of a 33-year-old man with a history of homozygous SS homozygous sickle cell anemia who consulted on March 24, 2020 for febrile dyspnea 11 days after the onset of symptoms. A nasopharyngeal swab was positive for SARS-CoV-2. His respiratory status worsened rapidly in the emergency room and then in ICU leading to severe ARDS requiring intubation, curarization, and venovenous ECMO. Hematologically, severe hemolysis associated with major thrombocytopenia without documented spinal cord injury was noted. Several transfusion exchanges are performed. The evolution was finally slowly favorable and led to discharge from the intensive care unit and then from the hospital. Conclusions This case recalls the importance of an increased prevention policy against COVID-19among the SCD population. In addition, from a therapeutic point of view, it advocates (1) a high preventive anticoagulation from the outset according to the level of D-dimers (2) the use of venovenous ECMO in this particular case, whereas this technique has had rather disappointing results in acute chest syndromes. (3) Unexpectedly, our patient did not develop pulmonary arterial hypertension (PAH) and acute cor pulmonale (ACP), whereas this is a common feature of ARDS during SCD. These last two observations suggest a different pathophysiology of pulmonary disorders in SCD patients in the case of SARS COv2. It could be associated with marked hypoxemia secondary to pulmonary vascular vasodilation.

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Association between severity of prenatally diagnosed hydronephrosis and receipt of surgical intervention postnatally among patients seen at a fetal-maternal center

BMC Urology ◽

10.1186/s12894-021-00822-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zoë G. Baker ◽

Arthi Hannallah ◽

Melissa Trabold ◽

Danielle Estell ◽

Cherry Deng ◽

...

Keyword(s):

Surgical Intervention ◽

Renal Scarring ◽

Tertiary Care ◽

Rank Test ◽

Kaplan Meier ◽

Hazard Ratios ◽

Age At Surgery ◽

History Of ◽

Pediatric Urologist ◽

Tract Infections

Abstract Background Hydronephrosis (HN) is the most common abnormality detected on prenatal ultrasound. This study sought to stratify outcomes of patients by severity of prenatal HN with postnatal outcomes. Methods This was a retrospective review of patients referred to a tertiary care fetal-maternal clinic with diagnosis of prenatal HN from 2004 to 2019. HN severity was categorized as mild, moderate, or severe. Data were analyzed to determine the association between HN severity and surgical intervention. Decision for surgery was based on factors including history of multiple urinary tract infections, evidence of renal scarring, and/or reduced renal function. Surgery-free survival time was represented by the Kaplan–Meier method, and hazard ratios were calculated using the log-rank test. Results 131 kidneys among 101 infants were prenatally diagnosed with hydronephrosis; 35.9% had mild HN, 29.0% had moderate HN, and 35.1% had severe HN. 8.5% of patients with mild HN, 26.3% of patients with moderate HN, and 65.2% of patients with severe HN required surgery. Patients with severe HN were 12.2 (95% CI 6.1–24.4; p < 0.001) times more likely to undergo surgery for HN than patients with mild HN and 2.9 (95% CI 1.5–5.3; p = 0.003) times more likely to undergo surgery than patients with moderate HN. Patients with moderate HN were 4.3 times more likely to require surgery than patients with mild HN (95% CI 1.5–12.9; p = 0.01). Median age at surgery was 11.8 months among patients with mild HN (IQR 11.7–14.1 months), 6.6 months among patients with moderate HN (IQR 4.2–16.4 months), and 5.4 months among patients with severe HN (3.7–12.4 months). Conclusion Among this cohort of referrals from a fetal-maternal clinic, severity of HN correlated with increased likelihood of surgical intervention. Continued assessment of patients with prenatal HN should be evaluated to best determine the role of the pediatric urologist in cases of prenatal HN.

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